Endoscopic surgery is often used to perform prostate, intra-uterine, bladder and urinary track surgery. The most common method of performing prostate surgery is to resect the enlarged prostate gland with an electrosurgical loop inserted into the urethra through an endoscope. The electrosurgical device shaves off small pieces of prostate tissue in order to enlarge the passageway, thereby providing the patient with relief. A problem with this method of surgery is that substantial bleeding occurs as the prostate tissue is being cut, making visibility through the endoscope difficult. Blood loss also complicates the surgical operation and lengthens the hospital stay. Additionally, this method of surgery is difficult to perform making extensive training necessary. Finally, the procedure is lengthy, taking up to 11/2 hours to perform.
Another method of performing prostate surgery is to insert an optical fiber which is optically coupled to a laser into the prostate gland through an endoscope. The laser energy conveyed by the optical fiber coagulates or cooks surrounding prostate gland tissue. In some instances, it is desirable for the optical fiber to include a tip which directs the laser energy laterally in order to make the procedure easier to perform. The coagulated tissue remains in place for about four to six weeks before the coagulated tissue falls off and is passed during urination. Therefore, the patient must endure a long period of discomfort land may need a catheter for passage of urine until the coagulated tissue is finally passed.
Another problem with performing prostate surgery with a laser is that current fiber optics having tips for directing light laterally are easily damaged during use. One common fiber optics tip for directing light laterally has an end which is polished at an angle. The polished surface has a reflective Coating for reflecting light conveyed by the fiber optic laterally with respect to the optical fiber. A problem with the reflective coating is that if charred tissue comes in contact with the coating during surgery, the coating burns off and no longer reflects light.
Another common fiber optics tip for directing light laterally is disclosed in U.S. Pat. No. 4,740,047. This tip has a glass dome surrounding the angled polished end of the optical fiber. The problem with this tip is that as tissue is coagulated, the heated tissue pops or explodes causing shock waves which commonly break the glass dome leaving pieces of glass within the patient.